Mountain Laurel Opco, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

MOUNTAIN LAUREL OPCO, LLC

Practice address

700 Leonard St
Clearfield, PA 16830-3245

Phone

(814) 765-7545

NPI assigned

Nov 9, 2021

Last updated

Nov 19, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Robert Kolman, LNHANPI 1811656440

Title

Operator

Phone

(917) 295-1882

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477219913. Details of each certification follow.

• CCN 395331 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 395331

Legal name

MOUNTAIN LAUREL OPCO LLC

Doing business as

MOUNTAIN LAUREL HEALTHCARE AND REHABILITATION CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

May 2, 1975

Last certification

Sep 26, 2024

Beds

240

Ownership / control type

Limited Liability Corporation

Organization structure

LLCProprietary

Incorporated

Sep 22, 2021 in OH

Enrollment address

700 Leonard St
Clearfield, PA 16830-3245

Nursing home name

MOUNTAIN LAUREL HEALTHCARE AND REHABILITATION CTR

Listed as

Mountain Laurel Healthcare and Rehabilitation CtrCCN 395331 · All quality measures

Overall star rating

2 of 5

Health inspections

1 of 5

Staffing

2 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

May 2, 1975

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

240127.5 residents per day on average

Penalties (3 years)

2Fines totaling $8,190

Processed by Care Compare on Aug 1, 2026.

Locations

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• Shippensburg Opco, LLC

  • Skilled Nursing Facility
  • Shippensburg, PA
  • NPI 1528702461

  BL Panho Trust, Mlspa LLC, Mlspa Trust, MVRK I LLC, Panho Capital Group LLC, Premier Management Support LLC

  CMS ownership

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert Kolman

  • Skilled Nursing Facility
  • Blountstown, FL
  • NPI 1811656440
  NPD Authorized official
• Brandon M Roscoe, M.D.

  • Family Medicine Physician
  • Du Bois, PA
  • NPI 1639394034
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1636416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637280000000",
    "number": "1477219913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 LEONARD ST",
            "city": "CLEARFIELD",
            "state": "PA",
            "postal_code": "168303245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 LEONARD ST",
            "city": "CLEARFIELD",
            "state": "PA",
            "postal_code": "168303245",
            "telephone_number": "814-765-7545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN LAUREL OPCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-09",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A",
        "authorized_official_last_name": "KOLMAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OPERATOR",
        "authorized_official_telephone_number": "917-295-1882",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert John Mollica, P.T.
• Orlinda Moore
• Samantha Leigh Morgan, MS, ATC, PES
• George C Mosch II, M.D.
• Melanie Marie Moskel, LPC
• Denise Lynn Mullins, MA CNS
• Ethan Muri, CRNP
• Debbie Jo Myers
• Nathaniel D. Yingling Cancer Center
• Olivia Neeper, PA-C

• Skilled Nursing Facility in Clearfield, PA
• Providers in Clearfield, PA by specialty
• Skilled Nursing Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.